In recent times, there have been reports of frequent breakdown of medical equipment such as the Magnetic Resonance Imaging (MRI), the Computed Tomography (CT) scan and the Linear Accelerator at the Lagos University Teaching Hospital (LUTH) Idi-Araba.

MRI is a noninvasive medical test that physicians use to diagnose and treat medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures.

A CT scan combines a series of X-ray images taken from different angles and uses computer processing to create cross-sectional images, or slices, of the bones, blood vessels and soft tissues inside your body.

A linear accelerator (LINAC) is the device most commonly used for external beam radiation treatments for patients with cancer. The linear accelerator is used to treat all parts/organs of the body. It delivers high-energy x-rays to the region of the patient’s tumour.

Meanwhile, LUTH is one of the first eight teaching hospitals that benefitted from the first phase of the Federal Government/Vamed Engineering Refurbishment project worth over N29 billion.

The Federal government/Vamed Engineering project was initiated in 2002 by the then President Olusegun Obasanjo Administration with a N17 billion contract to refurbish eight teaching hospitals in the six geopolitical zones of the country. The contract was later upgraded in 2007 to include six more teaching hospitals in a N12 billion contract.

Chief Medical Director (CMD), Prof. Chris Bode, told The Guardian: “LUTH got Vamed equipment more than eight years ago during President Olusegun Obasanjo’s regime. Obasanjo inaugurated them here. We have a CT scan and some X rays. The CT scan was a very old by now. It is an old model. We were repairing and repairing it until we refused to continue repairing it. That was why we went into a Public Private Partnership (PPP) with JNCI who brought in a 128 slides against the 16 slides CT scan from Vamed. The 128 slides CT scan from JNCI is the best of its kind in West Africa and it cost over N280 million. It is a PPP between JNCI and LUTH and it is working.

“We have replaced the CT scan because it had stopped working since every medical equipment has a life span. The fact that you brought equipment 12 years ago is not an assurance it will be useful today. I don’t know what it is like in the print industry. Are you using the same set of computers you used 12 years ago? As it is here on Earth, so it is in heaven. The MRI was placed when Prof. Akin Osibogun was just starting as the CMD, that was more than eight years ago, so it was already beginning to show signs of ageing.

So the MRI was not part of the equipment that LUTH got under Vamed project? Bode said: “No. But it was one of the first PPP. First Foundation brought it in but it broke down just before the day he needed it. That was why he had to go outside. People come here to do MRI when their machines break down.

So what did LUTH get from the Vamed project? He said: “Linear Accelerator. The Linear accelerator brought in by Vamed was manufactured by Electra in Austria- seven of them were brought into the country and only two are working now. One in Sokoto and one in Abuja are the only one working now. The one in Benin, Enugu, Lagos and another have not being working. Why? The one in LUTH broke down some months ago we were supposed to repair it. Let Messer Vamed come and repair it, and they couldn’t.

“Luckily Vamed is no longer representing the manufacturers. The new company that is representing the manufacturers has just today donated a $100,000 replacement of the part of the machine that broke down. They just brought it in today, Friday December 4, 2015. They promised that on December 14, 2015, engineers from South Africa and Nigeria would repair the damage and hopefully it will start working thereafter. But we are not going to wait only on that machine.”

Meanwhile, The Guardian gathered that part of the Vamed project was the training of biomedical engineers that could repair the machines when they broke down. However, the LUTH CMD said: “They didn’t train people up to the extent we wanted. They a kind of shielded it. The training was not what we expected. The training could have been better because we don’t have the engineers who can effectively man them. So we are always running back to them to say, ‘this has broken down, can you repair it.’ So we are also in the process of looking for how we can acquire more linear accelerators so that we have more than one here because we treat a lot of cancer patients on daily basis. People use to come from West, East and Central Africa to receive treatment here. The equipment that you use everyday in a hospital sometimes breaks down and you need to repair the place.

“Thanks to government, it is encouraging the increasing participation of the private sector in bridging that gap because the equipment is costly. A new linear accelerator now costs over $3 million. It difficult for the hospital to muster that kind of money but there are private investors who are capable.

“We want you to help us to impress upon the public to go into such partnerships that is equipment donation, adoption. Abroad people will say in memory of so person we endow you with this.

“We want a situation people will get to know through the press that LUTH sees over 70 per cent of people that don’t need to come to LUTH. Do you know that? For example, there is the primary health level where people with diarrhoea, headache and malaria should go. It has failed in many parts of Nigeria and so people don’t go there. When last did you take any member of your family to primary health care (PHC) level? People don’t believe in so many of them because they are not well equipped or so endowed. There is secondary level of health care by state governments, neighbor clinics where they should be doing hernia. I shouldn’t be doing a baby’s hernia’s here. I shouldn’t be doing circumcision here. I shouldn’t be doing simple operations, bread and butter stuff.

“We are supposed to be handling the big cases and complications as a tertiary health care level. Now we are so burdened. Anybody that has chest pain is coming to LUTH as if it is heart attack. Whereas they should see their primary health care physicians who will do electrocardiogram (ECG) and say it is just this, go and take that. It is only the specialized cases they should refer to us and once we treat those specialized cases or complications, we should refer them back to their primary health doctors.

“So when somebody comes with a cardiac condition and the doctors have treated him, they keep coming back, they keep coming here. So our systems is over burdened with cases from the primary and secondary care levels and that is one of the things we need to address. Our country will need to empower those other levels too at the local government level for PHC and state government level to allow for secondary level to function as they should.”

On the issue of alleged water scarcity, Bode said: “Because of the inconsistency of the state water supply, I think it is only 10 per cent of the state that enjoy pipe bornez water. I don’t know what you use in your own house, I use borehole. We had to sink boreholes in several places in the hospital powered by electricity. We are rehabilitating even the pipes in the wards. They have done some of the wards and they have awarded contracts for people to make sure that water runs in every ward. But on top of that since we came in, the hospitals’ main water treatment plant is currently being rehabilitated so that we can pump water from one central area and just leave the boreholes as reserves.

“But for anybody to say they buy water from outside. Have you ever seen a Meruwa (water carrier)? I have never seen anybody. I think it should be a third party-hear-say that people buy water in LUTH. If there is a breakdown of anything in LUTH there is a WhatsUp group that alerts us that so and so are not working, Chief Engineer will get there immediately. Last night I called the chief engineer and this morning I went there almost immediately. So anybody that says power does not fail in his or her house will think that …

Another issue is that of attitude of health workers. How can people channel their complains? Bode said: “We have the SERVICOM office open all the time. People should use it. They can phone in, they can send letters. With the SERVICOM group your problem must be solved that way otherwise you can complain higher. They can complain to the Chairman Medical Advisory Committee (CMAC), they can complain to the deputy CMAC, they can ask for the name of their consultant and complain to them.

“You have the right to ask who is my doctor? What is your name? Can you explain to me what is wrong with me? How am I been treated and what is the next thing? That is one area because of the bulk of cases we handle we can do better on. I wish this person who is now complaining had called me. I would have answer and said, ‘okay let me get back to you.’

“When we did a study on the complaints that patients have. Do you know that more relations complain than patients because when relatives come, they will say, ‘they have not seen him since morning,’ while he is just coming from work by 6pm. They will now expect the consultant to be hanging around during visiting hours. But when you check their case files you will notice that more than one consultant has seen them. The difference between here and private hospital is that in private hospital the doctors is around all the time but here that is not so. We are not around during visiting hours, we allow relations to see the patients. But any relations that have questions can always do, that is why the name of the consultants is written at the bed heads.”